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Published on: December 6, 2016
Craniofacial, Dental, and Upper Airway Morphologic features of Severely Obese Adults with Obstructive Sleep Apnea
Liang Xia1, Wenxin Jiang2, Kan Yao1
1Department of Oral and Cranio-maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, Shanghai, China; National Center for Stomatology, Shanghai, China; National Clinical Research Center for Oral Diseases, Shanghai, China; Shanghai Key Laboratory of Stomatology, Shanghai, China.
Introduction And Aims:
Craniofacial and upper airway development are closely associated with obstructive sleep apnea (OSA). This study aimed to analyse craniofacial and upper airway characteristics in adults with severe obesity and OSA to better understand the disease.
Methods:
Ninety-four severely obese patients (BMI ≥ 35) underwent polysomnography (PSG) and lateral cephalograms to assess craniofacial and upper airway morphology. Cephalometric and airway measurements were analysed combined with PSG findings to evaluate craniofacial and airway features in severe OSA patients.
Results:
The study included 50 males and 44 females, with a mean age of 33.05 years and an average apnea-hypopnea index (AHI) of 52.22 events/h. Males had significantly higher AHI, neck circumference (NC), waist circumference, and arousal index, along with lower average and minimal oxygen saturation levels compared to females. Cephalometric analysis showed that males had greater mandibular ramus length and Sella-to-condyle vertical distance. Cross-correlation analysis indicated significant associations between AHI and both NC and the mandibular plane to Sella-Nasion line measurement. The Frankfurt horizontal plane to Nasion-Pogonion plane was correlated with BMI, NC, and waist circumference. Hyoid bone position was linked to tongue volume, Y-axis angle, pharyngeal airway space, facial height, and lip length. Tongue volume correlated with mandibular ramus length, upper anterior tooth angle, and upper lip length. Snoring index was associated with pharyngeal airway space and tongue height, while pharyngeal airway space width was related to oxygen saturation levels.
Conclusion:
Severe obese individuals, particularly males, experience more severe OSA symptoms. A complex interplay exists between OSA, craniofacial morphology, and airway structure.
Clinical Relevance:
Craniofacial and dental features are consistent in severe obese OSA patients, suggesting that obesity-related fat accumulation has a greater impact on respiratory function than skeletal structure or dental alignment.
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